Systems and methods for monitoring chronic over-pacing (COP) to the heart are discussed herein. In an embodiment, a system includes a receiver circuit to receive information about pacing rates of a plurality of paced heart beats, and a pacing analyzer circuit to generate a pacing rate distribution using pacing rates of the plurality of the paced heart beats. The pacing rate distribution includes a pacing rate histogram. The pacing analyzer circuit may recognize a morphological pattern from the pacing rate distribution, and detect a COP indication using the extracted feature. A programmer circuit adjusts one or more therapy parameters in response to the detected. COP indication.

An implantable system for treating a heart contains a processor, a memory unit, a treatment unit including a treatment electrode, and a detection unit for detecting a cardiac event requiring treatment. The memory unit includes a computer-readable program, which prompts the processor to perform the following steps: a) detecting by way of the detection unit whether a cardiac event to be treated has occurred in the heart; b) if a cardiac event to be treated has occurred, determining a position of the treatment electrode or determining a variable correlating with this position; and c) comparing the position of the treatment electrode or the variable correlating with the position to a reference variable, and carrying out, or not carrying out a cardiac treatment by way of the treatment unit and the treatment electrode as a function of the position of the treatment electrode or the variable correlating with the position.

An implantable system for treating a heart contains a processor, a memory unit, a treatment unit including a treatment electrode, and a detection unit for detecting a cardiac event requiring treatment. The memory unit includes a computer-readable program, which prompts the processor to perform the following steps: a) detecting by way of the detection unit whether a cardiac event to be treated has occurred in the heart; b) if a cardiac event to be treated has occurred, determining a position of the treatment electrode or determining a variable correlating with this position; and c) comparing the position of the treatment electrode or the variable correlating with the position to a reference variable, and carrying out, or not carrying out a cardiac treatment by way of the treatment unit and the treatment electrode as a function of the position of the treatment electrode or the variable correlating with the position.

A transport system for delivery or retrieval of a biostimulator, such as a leadless cardiac pacemaker, is described. The biostimulator transport system includes a docking cap supported by a bearing within a bearing housing. The bearing allows relative rotation between a torque shaft connected to the docking cap and an outer catheter connected to the bearing housing. The bearing housing and the docking cap include respective bearing retainers that constrain the bearing within the bearing housing without a weld attachment. The weldless retainers of the biostimulator transport system provide a robust mechanical securement of the bearing that is not vulnerable to corrosion. Other embodiments are also described and claimed.

A leadless pacemaker device configured to provide for an intra-cardiac pacing, including: processing circuitry configured to generate ventricular pacing signals for stimulating ventricular tissue, and a reception device for receiving a sensing signal indicative of an atrial activity, wherein the processing circuitry is configured to detect an atrial event derived from said sensing signal, wherein the atrial event is a valid atrial sense event, where a series of atrial events lie within a range for a normal atrial rate, and/or when the atrial rate variability is within a certain range indicating a regular atrial rhythm, wherein in case a valid atrial sense event is detected, the processing circuitry is further configured to: determine ventricular pacing events according to atrial events, calculate ventricular-atrial time delays, determine a correction value based a measured time delay and the calculated time delay, and adjust the ventricular pacing timing based on the correction value.

An implantable medical device for stimulating a heart, comprising a control unit, a memory unit, a stimulation unit for stimulating a cardiac region of a heart, and a detection unit for detecting an electrical signal of the heart. The memory unit comprises a computer-readable program that causes the control unit to perform the following steps: a) detecting capture thresholds during an observation period, each capture threshold detected in response to a sequence of pacing pulses delivered by the stimulation unit; b) storing the detected capture thresholds in the memory unit; c) determining threshold-to-threshold differences between two consecutive capture thresholds; and d) if a maximum determined threshold-to-threshold difference within the observation period is equal to or greater than a predetermined limit, adjusting a pacing output of the stimulation unit based on the maximum capture threshold determined within a first time period which is equal to or shorter than the observation period.

An implantable medical device includes a header configured to be mounted to an end of a device housing that contains an electronics module therein. The header includes an antenna, a sensing electrode, and a header body that at least partially surrounds the antenna and the sensing electrode. The sensing electrode includes a first body portion, a second body portion, and a bridge portion that mechanically and electrically connects the first and second body portions. The first body portion is at least partially exposed to an external environment along a first side of the header, and the second body portion is at least partially exposed to the external environment along a second side of the header that is different from the first side.

A leadless pacemaker, and method for storing event data therein, comprising a central processing unit, a first logic circuit configured to generate event data based on a first event occurring during operation of the leadless pacemaker, a first hardware event counter configured to be incremented if specific event data are generated by said first logic circuit, a first memory unit comprising a first bit configured to be set if said first hardware event counter is incremented to a first maximum number of counts, a second memory unit communicating with said first memory unit, wherein said central processing unit is configured to transfer said first bit to said second memory unit, a first RAM event counter in a random access memory of said leadless pacemaker, wherein said central processing unit is configured to increment said first RAM event counter if said first bit is transferred to the second memory unit.

A medical device is configured to sense at least one cardiac electrical signal and generate pacing pulses according to a first pacing therapy by generating pacing pulses for delivery to a first combination of ventricular pacing sites including at least one ventricular conduction system pacing site. The medical device may be configured to determine a ventricular conduction condition based on a QRS signal feature of the sensed cardiac signal during the first pacing therapy. The medical device may change to a second pacing therapy different than the first pacing therapy based on the determined ventricular conduction condition.

A leadless implantable medical device (IMD) and method of using same are provided. The IMD comprises: a housing, a fixation element, electrodes configured to sense electrical cardiac activity (CA) signals over a period of time, an HS sensor configured to sense HS signals over the period of time, memory to store specific executable instructions, and one or more processors. The one or more processors and method: identify a characteristic of interest (COI) of a heartbeat from the CA signals, calculate a center of mass (COM) for at least one HS based on the HS signals to obtain a corresponding at least one HS COM, and calculate at least one of a therapy-related (TR) delay or a sensing-related (SR) blanking interval (BI) based on the at least one HS COM.